| Ppm Wisconsin Llc | |
|
W175n11117 Stonewood Dr Ste 100 Germantown WI 53022-6505 | |
| (888) 253-6598 | |
| Not Available |
| Full Name | Ppm Wisconsin Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | W175n11117 Stonewood Dr Ste 100, Germantown, Wisconsin |
| Authorized Official Name and Position | Lee Johnson (TREASURER) |
| Authorized Official Contact | 2084011369 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ppm Wisconsin Llc W175n11117 Stonewood Dr Ste 100 Germantown WI 53022-6505 Ph: (888) 253-6598 | Ppm Wisconsin Llc W175n11117 Stonewood Dr Ste 100 Germantown WI 53022-6505 Ph: (888) 253-6598 |
| NPI Number | 1811601776 |
|---|---|
| Provider Enumeration Date | 01/05/2023 |
| Last Update Date | 01/05/2023 |
| Medicare PECOS PAC ID | 1456797729 |
|---|---|
| Medicare Enrollment ID | O20240308000896 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811601776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Turgut Z Zia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699783894 PECOS PAC ID: 6204804396 Enrollment ID: I20040916001234 |
| Provider Name | Andrea A Jurgilanis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952079568 PECOS PAC ID: 8224428263 Enrollment ID: I20211206000970 |
| Provider Name | Rachel Lynn Squibb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750144895 PECOS PAC ID: 7810439460 Enrollment ID: I20240611000930 |
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